Molecular epidemiology of HIV/AIDS and related diseases in Southern Africa

南部非洲是世界上艾滋病毒-1感染流行率最高的地区，为改善这种情况，优先采取以下战略：为了了解非洲南部HIV感染的自然历史，2 .为艾滋病毒感染者开发负担得起的有效治疗方法；3 .研制安全有效的艾滋病毒疫苗；4 .制定和实施预防艾滋病毒母婴传播的机制；开发一种更快的结核病耐药监测方法。为了了解HIV感染的自然病史，我们招募了无症状患者，随访3年。结核病被确定为这些患者死亡的最高原因。为了确定一种有效和负担得起的艾滋病毒治疗药物，进行了一项双盲研究。血浆中维持高药物水平的患者CD4计数较高。为了确定HIV-1毒株在赞比亚的分布以用于疫苗开发，我们分析了卢萨卡的核苷酸序列，发现HIV-1 env亚型C样占主导地位，同时出现了HIV-1 env亚型d样和g样。有必要继续进行研究，以监测赞比亚，特别是沿边界地区艾滋病毒-1流行病的变化动态。为了确定一种有效的预防母婴传播的方法，我们发现在赞比亚，宫内传播和分娩过程中传播艾滋病毒对婴儿的传播同样重要。我们在卢萨卡发现结核耐药分枝杆菌的高发率。

Southern Africa has the highest prevalence of HIV-1 infection in the world and the following strategies have been priority in order to improve this situation :1. To understand the natural history of HIV infection in southern Africa,2. To develop an affordable and effective treatment for HIV infected people,3. To develop a safe and effective HIV vaccine,4. To develop and implement a mechanism that would prevent mother to child transmission(MTCT)of HIV,5. To develop a faster TB drug-resistant monitoring assay.In order to understand the natural history of HIV infection, we recruited asymptomatic patients and followed them for 3 years. TB was identified as the highest cause of death in these patients.A double blinded study was carried out in order to determine an effective and affordable drug for HIV treatment. CD4 counts were high in patients who maintained high drug levels in their plasma.To determine the distribution of HIV-1 strains in Zambia for vaccine development, we analysed the nucleotide sequences in Lusaka and found the predominance of HIV-1 env subtype C like with the emergence of HIV-1 env subtypes D-like and G-like. There is a need for continued studies to monitor the changing dynamics of the HIV-1 epidemic in Zambia, especially along the bordering areas.To determine an effective prevention method of MTCT, we found that intrauterine transmission and during delivery were equally important for the transmission of HIV to babies in Zambia.We found a high rate of TB drug-resistant mycobacterium in Lusaka.